Living With Hypothyroidism? How Nutritional Therapy Can Support an Underactive Thyroid

An underactive thyroid, also known as hypothyroidism, is a common yet often misunderstood condition that can significantly affect day-to-day wellbeing. Many people live with symptoms for years before receiving a diagnosis and even once diagnosed, some continue to feel unwell despite treatment.

Nutritional therapy cannot diagnose or treat medical conditions, nor replace medical care. However, it can play a valuable supportive role in optimising nutrition, supporting thyroid function and improving overall wellbeing alongside appropriate medical care.

What Is an Underactive Thyroid?

The thyroid is a small, butterfly-shaped gland located at the front of the neck. It produces hormones that regulate metabolism, energy production, body temperature, digestion, heart rate and mood.

Hypothyroidism occurs when the thyroid does not produce enough thyroid hormones to meet the body’s needs. This slows down many bodily processes, which is why symptoms often develop gradually and can be easily overlooked or attributed to stress, ageing or lifestyle factors.

How Common Is Hypothyroidism?

Hypothyroidism is one of the most common endocrine disorders worldwide.

• In the UK, it is estimated that around 2–3% of the population has an underactive thyroid

• It is significantly more common in women, particularly over the age of 35

• Autoimmune thyroid disease (such as Hashimoto’s thyroiditis) is the most common cause in developed countries

• Many cases remain undiagnosed, especially in the early stages

This means a large number of people may be experiencing symptoms without clear answers.

Symptoms of Hypothyroidism

Symptoms can vary widely from person to person and may develop slowly over time.

Symptoms may include:

• Tiredness

• Increased sensitivity to cold

• Constipation

• Dry skin

• Weight gain

• Puffy face

• Hoarse voice

• Coarse hair and skin

• Muscle weakness

• Muscle aches, tenderness and stiffness

• Thinning hair

• Slowed heart rate (also known as bradycardia)

• Depression

• Memory problems

  
  

Because these symptoms overlap with many other health conditions, hypothyroidism can be challenging to identify without appropriate testing.

Nutrients That Can Support (and Hinder) Thyroid Health

Nutrition plays an important role in thyroid health, as the production and activation of thyroid hormones depend on adequate nutrient availability. Within nutritional therapy, the focus is on supporting normal physiological function.

Nutrients That May Support Normal Thyroid Function

• Iodine

  Required for the production of thyroid hormones. Both low and excessive intakes may negatively affect thyroid function, which is why iodine supplementation is not routinely recommended without professional guidance.

  
  

• Selenium

  Supports the conversion of thyroxine (T4) into the more active triiodothyronine (T3) and contributes to antioxidant protection of thyroid tissue.

  
  

• Zinc

  Involved in thyroid hormone metabolism, immune function and protein synthesis.

  
  

• Iron

  Adequate iron status is important for thyroid hormone production. Low iron levels may also contribute to fatigue and reduced exercise tolerance.

  
  

• B Vitamins (particularly B12)

  Support energy metabolism and neurological function. Low B12 status is relatively common and may contribute to fatigue, low mood and cognitive symptoms.

  
  

Where appropriate, nutritional therapists may recommend further investigation via a GP to assess nutrient status before considering supplementation.

Nutrients and Dietary Factors to Avoid

• Excess iodine intake, particularly from supplements or frequent seaweed consumption, may disrupt thyroid function in susceptible individuals.

• Highly restrictive or elimination diets may increase the risk of nutrient inadequacy if not appropriately managed.

• Very low-calorie diets can signal energy conservation within the body, potentially exacerbating symptoms such as fatigue and cold sensitivity.

• Diets high in ultra-processed foods may contribute to inflammation, blood sugar dysregulation and suboptimal nutrient intake.

  
  

Within nutritional therapy, the aim is to support thyroid health through balance, adequacy and individualisation rather than restriction or extreme dietary approaches.

The Conventional Medical Approach

The standard medical treatment for hypothyroidism typically involves thyroid hormone replacement medication, such as levothyroxine. This aims to restore thyroid hormone levels to within a normal range and is often highly effective at preventing more serious complications.

Medical management is essential and should always be overseen by a qualified healthcare professional. However, some people continue to experience symptoms even when blood tests appear “normal”.

This is where nutritional therapy may offer additional support, working alongside medical treatment rather than replacing it.

How I Support Hypothyroidism as a Nutritional Therapist

As a nutritional therapist, my role is to look beyond the diagnosis and support the body as a whole. Thyroid health is closely connected to digestion, stress, nutrient status, blood sugar balance and inflammation.

1: Comprehensive Case History

I begin by exploring:

• Symptoms and health history

• Current medication and medical care

• Diet, lifestyle, stress levels and sleep

• Digestive health and energy patterns

  
  

2: Identifying Nutrient Gaps

I assess whether key nutrients involved in thyroid hormone production and conversion may be lacking. This is always done carefully, with food-first strategies and appropriate referrals for testing where necessary.

3: Supporting Blood Sugar Balance

Blood sugar instability can place additional stress on the thyroid and adrenal system. I help clients structure meals to support steady energy and reduce fatigue and cravings.

4: Gut and Digestive Support

Healthy digestion is essential for nutrient absorption and immune balance. Addressing bloating, constipation or food sensitivities can be an important part of thyroid support.

5: Reducing Inflammatory Load

We work on identifying dietary and lifestyle factors that may be contributing to inflammation, while supporting the body’s natural detoxification pathways.

6: Lifestyle and Stress Support

Stress management, sleep quality and appropriate movement all play a role in hormone health. These are gently addressed in a way that feels realistic and sustainable.

Throughout this process, support is always individualised, evidence-based and designed to complement medical treatment.

When Nutritional Therapy May Be Helpful

You may benefit from nutritional therapy if:

• You have been diagnosed with hypothyroidism but still feel unwell

• You experience symptoms but have been told your tests are “normal”

• You want to support your thyroid naturally alongside medical care

• You are looking for a personalised, root-cause approach

  
  

Final Thoughts & Call to Action

Living with an underactive thyroid can feel frustrating and exhausting, especially when symptoms persist despite treatment. While nutritional therapy cannot cure hypothyroidism, it can offer meaningful support by addressing underlying imbalances and improving overall wellbeing.

If you would like personalised support tailored to your unique health needs, I invite you to book a discovery call to explore whether nutritional therapy is right for you.

Small, targeted changes can make a meaningful difference when they are guided by the right support.